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LEEP (Loop Electrosurgical Excision Procedure)

Loop Electrosurgical Excision Procedure, or LEEP, is a procedure to remove tissue from the cervix that is not normal and may lead to cancer. 

The cervix is the opening of the uterus (womb) and is located at the top of the vagina. LEEP is usually done in the doctor’s office or clinic.

How to Prepare 

  • Two days before the procedure, avoid sex and do not use creams in or around the vagina. 
  • Do not douche. 
  • Take an over-the-counter pain medicine 2 hours before the procedure. Ibuprofen (Advil, Motrin) and acetaminophen (Tylenol) are options.

How it is Done 

  • You will be given ibuprofen to help with any discomfort from the procedure. 
  • Go to the bathroom and empty your bladder before the test. 
  • Remove all metal, including any piercings, if possible 
  • Be sure to let the nurse or doctor know if you have any metal inside your body that cannot be removed. 
  • You will be asked to undress from your waist down and will have a paper sheet to cover you. 
  • A sticky pad, called a grounding pad, will be placed on your thigh. It is cold. 
  • You will be asked to lie down on the exam table and place your feet in holders at the end of the table, called stirrups. 
  • Let your knees fall to the sides. Take slow, deep breaths to relax the muscles around your vagina during the exam. 
  • A tool shaped like a duck bill, called a speculum, will be placed into the opening of your vagina to allow your provider to see inside your vagina. 
  • An iodine solution is applied to the cervix to make abnormal cells easier to see. This solution also cleans the cervix to prepare for the procedure
  • Your provider will look at your cervix with a big magnifying glass, called a colposcope. The colposcope looks like a pair of binoculars on a stand. The colposcope does not go inside of you. • Your cervix is numbed with a local anesthetic. This is the same medicine the dentist uses to numb you for dental work. It can cause your heart to beat fast and may make you feel shaky. This will pass in a few minutes. 
  • A wire loop is inserted through the vagina. The abnormal tissue from the cervix is removed with this loop. This tissue will be sent to the lab for closer study. 
  • You may feel mild cramping during the procedure. 
  • It is important that you do not move while the procedure is being done.

Possible Risks 

Your provider will review these risks with you before the procedure. 

  • Rare risk of infection or heavy bleeding. 
  • Chance not all abnormal tissue will be removed with this procedure, and you will need more surgery. 
  • Very rare risk of preterm labor with pregnancies that happen after this procedure.   

Caring for yourself after 

It will take several weeks to heal from this procedure. Plan to rest for the next week. You may have some bleeding, no more than a heavy period, for a few days and light bloody discharge for a few weeks. 

  • Place nothing in the vagina for 6 weeks after the procedure. This includes no sexual intercourse, no tampons, and no douching. This will reduce your risk of bleeding from the area that is healing. 
  • Eat a normal diet. 
  • Take ibuprofen (Advil, Motrin) or acetaminophen (Tylenol) or similar medicine as directed on the bottle. 
  • The discharge may first look like brownish-black coffee grounds, and you will have some bleeding, which should be similar to a period. In time this will change to a yellow watery discharge. You may wear a pad. 
  • You may take a shower. Do not take a tub bath, use a hot tub or go swimming for 6 weeks as this increases your chance for infection.

Call if you have: 

  • A lot of bleeding where you soak a pad in an hour 
  • Severe abdominal cramps or pain that gets worse over time 
  • Chills or fever of 100.4 degrees Fahrenheit or 38 degrees Celsius or higher 
  • Vaginal discharge that has a bad odor

Follow Up 

You will receive the results and instructions for future follow-up appointments. A follow up visit will be scheduled for you. It is very important that you keep all of your appointments.

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